Representers – call to AIDS action! Click Here.
One of our much loved Represent readers, Cornelia, who is doing her Masters in Aids Research, has kindly compiled our WORLD AIDS DAY feature for the 1 December – it contains the LATEST information on HIV/AIds in SA. Thank you Cornelia for taking the time to fill us in and helping us understand what is going on right now. You will see at the end …
of this posting there is a document that highlights the LATEST information regards HIV/AIds – if you would like the complete document, please click here to email Cornelia.
Represent sends our full support and respect out to all those people infected and affected by HIV/AIDS. Let’s work together at combatting the spread of this scourge and communicating the positive messages around living with HIV/AIDS.
Take a moment to read her thoughts, we’re asking all Represent readers to make a commitment to the fight. To email Cornelia please click here.
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Aids is not a disease,
although the virus has killed millions.
Aids is not a set of statistics,
although the numbers are horrific.
Aids is not a conference in Durban.
Aids is not a presidential PR problem.
Aids is not advertisements and education programmes, although these help.
Aids is a feeling of hopelessness and despair.
Aids is young people who believe they’re immortal.
Aids is a secret known by everyone.
Aids is not knowing what’ll happen to your children when you’re gone.
Aids is people who are part of families.
Aids is everyday life carrying on against the odds.
– 13-year-old child in Natal
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The 1 December is World AIDS day. Historically, World AIDS Day has been organised by UNAIDS, but this year (2005) UNAIDS handed over responsibility for World AIDS Day to an independent organisation known as The World AIDS Campaign (WAC).
Every year World AIDS Day is themed. This year the theme is “Stop AIDS: Keep the Promise”. “Keep the Promise” is an appeal to governments and policy makers to ensure they meet the targets they have agreed to in the fight against HIV and AIDS.
This theme is however not specific to World AIDS Day alone, but to the work the WAC does throughout the year. It will also remain the focus until 2010.
“If we were to find ourselves in a situation where only the elite and rich are protected from the biological, social and economic devastation caused by HIV, it would have been our choice. If all of us became more acutely aware of our own agendas, and how they assist or impede the realization of a healthy South Africa, the future may arrive sooner than what we originally contemplated. Ultimately, it is the beliefs and values held dearest by people that will determine how we overcome the epidemic.” (SOUTH AFRICAN BUSINESS COALITION AGAINSTS HIV/AIDS, MONTHLY NEWSLETTER, Edition Six, May 2005)
Everyone can make a difference! Make a promise (and keep it) to:
– Raise awareness of HIV and AIDS in your area
– Protect yourself and your partners.
– Get tested (on a regular basis) and encourage others to do the same
– Educate yourself as much as possible (knowledge is power)
Educate yourself:
The article at the end of this posting contains some of the latest information on HIV, including:
New developments in treatment options including clinical trials for which you may volunteer
– Information on scientifically proven alternative therapies and nutritional advise
– Information on Post Exposure Prophylaxis (PEP) – e.g. rape
– Is it safe for HIV positive people to have sex? YES!
– Information on pregnancy and birth for HIV positive women
– Statistics on how many people are infected worldwide & in SA, and how HIV affects the SA economy & civil society.
2. HIV management course
This is an intensive 3-day course presented by the SA HIV clinician’s society and other individuals at the Discovery Institute. The price is very reasonable (R560.00), since it is subsidised by Discovery Health. Everyone is welcome, whether professionals or lay-people! Contact The Foundation for Professional Development to book yourself onto the course. Their telephone number is (012) 481-2034 /2076 /2092 /2101 /2038. For those who are medical professionals, this course will count towards your professional development points.
3. Internet Links:
The World AIDS Campaign) (WAC)
World Health Organization’s HIV initiative
Report on the impact of HIV AIDS on business in South Africa
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HIV update
World AIDS Day 2005
THIS IS PART OF A MUCH LONGER DOCUMENT THAT YOU CAN GET FROM CORNELIA – click here to email her.
Introduction to document:
Firstly, information regarding HIV and AIDS is constantly changing. The facts gathered in this document were accurate at the time it was compiled. Secondly, it is important to remember that we don’t treat statistics – we treat and care for real people. The statistics mentioned below are meant to INSPIRE you to take action by playing your part in controlling this epidemic. The figures are heartbreaking, but there is still hope!
Is HIV / AIDS really such a big threat?
Despite encouraging signs that the AIDS epidemic is beginning to be contained in a small, but growing number of countries, it continues to expand worldwide, according to a report released by UN Secretary-General, Kofi Annan (United Nations, New York, 2 June 2005). The World Health Organisation estimates that 39.4 million [35.9 million – 44.3 million] people are living with the HIV worldwide.
What is the situation in South Africa?
South Africa and its neighbours are placed at the epicentre of the HIV/AIDS pandemic. Sub-Saharan Africa is home to just 10% of the world’s population, yet 65 – 70% of those infected with HIV reside in this region (UNAIDS/WHO, 2004).
Estimates of the overall prevalence in SA vary from source to source, but all put the figure at between 4 and 6 million people living with HIV/AIDS in this country (UNAIDS/WHO, 2004). Connolly and colleagues (2004) published an HIV prevalence of 11.4% in South Africa’s general population. However, certain hospitals report that up to 74% of their patients are infected with the virus (Barnard, 2003).
At present more than 10% of South Africa’s children are likely to have lost at least one parent by the time they are 9. The study that produced this finding warns that South Africa should anticipate a substantial increase in orphans in the near future (Bateman, 2004).
Impact on South African Economy
HIV/AIDS has the potential to impact severely on the South African economy. This is because HIV affects people in the most productive age group. Data produced by the South African Bureau for Economic Research showed that, of the 1 006 companies sampled across various sectors, almost one-third reported a negative effect from HIV/AIDS on profits and more than half expected the epidemic to have an adverse effect on profits within five years (Ellis and Terwin, 2003).
So far, only a small number of companies had started to provide their employees with ARVs. AngloGold found that providing HIV drugs to its workers with AIDS would add $4-6 (up to 2%) to the cost of producing an ounce of gold. But if no action was taken, that cost could rise to $9 per ounce. If you want to find out how your company can make a difference to its workforce check out Red Ribbon.
THERE IS STILL HOPE!
Although the statistics paint a bleak picture, there is hope! Many developments are about to be released to the public, many of which come out of South African research. The field of HIV research and patient management in very specialized. Whatever we think we know for sure today could be completely obsolete within months… even weeks. Never before in the history of mankind has so much time and resources been spend on investigating a disease.
Vaccines:
A protective vaccine against HIV is proving elusive. Scientists across the globe have been collaborating in this effect and we are now at the point where many believe this direction should be abandoned (Esparza, 2005). Nevertheless, we are on the verge of releasing some novel therapeutic vaccines. A therapeutic HIV vaccine would serve to prevent the virus from entering the cells once in one’s blood, but would of course have it’s own drawbacks in terms of side effects. A therapeutic vaccine would have to be taken on an ongoing basis similarly to antiretroviral therapy (ART).
In addition to this we’re hoping that a Herpes Virus Vaccine will be released early in 2006. The significance of this in HIV management is huge. Co-infection with herpes virus in HIV infected individuals is common and it “helps” HIV in the body, as does TB and many other infections.
Asprin
The medical community in South Africa couldn’t understand why some of the treatments dispensed by traditional healers have such good results. Eventually it was found that they (in particular Willow Bark) contain salicyclic acid (an asprin-like compound). It is now known that salicyclic acid (asprin) increases CD8 cells (CD8 cells have the ability to directly fight HIV).
HIV clinicians now recommend that all HIV positive individuals take Asprin (20mg per kg in divided doses) as long as the person isn’t thombocytopenic (has a deficiency of platelets in the blood) and if the kidneys will be monitored. Please note that it is essential to drink 3% one’s body weight in water when on this therapy. However, EVERYONE (whether HIV positive or not) should drink one and a half to two and a half litres water per day anyway.
HIV Clinical Trials in Homeopathy:
One clinical trial employing a novel homeopathic treatment in HIV started in 2005 and is being conducted through the University of Johannesburg. A few more (HIV positive) participants are still required for this trial and those interested may contact Tanith Davidson for more information. Those interested may not be on ART at this time.
Another (double-blind, placebo controlled) clinical trial, employing a different homeopathic treatment (also through the University of Johannesburg) will start in the first half of 2006. Thirty HIV positive, male or female individuals of any race (aged 18-45 years), who are not currently on ART and who have a CD4 count above 250 cell/mm3 are invited to participate. Individuals (or company HIV programme managers) may contact Cornelia Botha for more information. Additional funding is also welcome!
Both the above-mentioned clinical trials are testing Homeopathic medicines that already have proven efficacy in HIV treatment. In addition to this, previous trials produced no adverse reactions or side effects. In particular, the medicine for the second trial (that will be starting in 2006) produced the following results in previous trials:
1. Between 1995 and 1997 Brewitt and colleagues (2002) conducted two double-blinded, placebo-controlled clinical trials and two follow-up studies to evaluate the efficacy of hoGFs. Treatment with hoGFs increased CD4+ cell, CD8+ cell and naýve cell (CD45RA) counts, reduced general inflammation as measured by erythrocyte sedimentation rate, decreased viral load, protected tissue integrity, maintained LBM, reduced the incidence of opportunistic infections and hospitalisations, and produced no toxic or adverse events.
2. Da Silva (2004) went on to test the efficacy of hoGF’s in the treatment of HIV positive children in South Africa and reported improvements in height, head circumference, quality of life and common symptoms of HIV/AIDS.
(Homeopathic medicines, usually referred to as homeopathic remedies, work by stimulating self-regulatory and self-recovery mechanisms).
Present-day treatment options:
We treat HIV infection because:
– Saves lives
– Reduces transmission
The lower the viral load the lower the likelihood of transmission!
Reducing the viral load reduces progression to AIDS and death.
– Increases naýve CD4+ T subsets (rebuilds immune system)
– Decreases clinical events (e.g. Opportunistic Infections)
– Prevents Post Exposure and Mother-to-child-transmission (MTCT)
Treating HIV (even with ART) does not eradicate the infection! “In patients who have had the best possible response to HAART (Highly Active Antiretroviral Therapy), there is no significant decay of the latent reservoir after five to seven years. Even if the reservoir consists of as few as one million cells, it would take 73 years for this reservoir to decay.” (Robert Siliciano of Johns Hopkins University).
What are “reservoirs”?
Only 2% of the virus is found in the blood. Thus, when we measure VL (viral load), we are measuring only 2% of the virus present in the body. The rest is “hiding” from us (and our immune system’s) detection in “sanctuaries”. These include lymph nodes, the central nervous system (e.g. the brain) and the genital tract.
The foundation of ART is the long-term management of a chronic illness. The aim of treatment is the complete suppression of viral replication & immune reconstruction.
South African Guidelines for ART
“CD4+ cells more than 350 ===> WAIT!
“CD4+ cells less than 200 ====> TREAT!
“AIDS defining illness present (regardless of CD count and viral load) ===> TREAT!
“CD4+ cells 200-350 and viral load less than 55 000 ====> TREAT!
At present, only 1 out of every 25 000 people who are eligible for ART are receiving treatment in Southern Africa (Ijumba et al, 2004). The South African Government faces the challenge of implementing the largest public health intervention for HIV/AIDS the world will see (Ijumba et al, 2004) with VERY limited infrastructure and resources (Ncayiyana, 2004; Department of Health, 2003).
In addition to this, the SA Department of Health is concerned about developing widespread ART resistance (due to less than 95-99% compliance on the part of those taking the drugs). This would be a disaster of virtually immeasurable proportion! A recent study conducted in the US concluded that an estimated 76% of viraemic patients had resistance to one or more antiretroviral drugs (Richman et al, 2004).
Some things that decrease T helper cells:
If your 4 month CD4 count check show an unexplained decrease check out the following facts that can cause this before investigating ART resistance:
– New infections with HIV once already HIV positive
– Recurrent infections
– TB
– Pregnancy
– Loss of weight >10% basal
– Medications: e.g. Hydrea, chemotherapy, corticosteroids (e.g. prednisone if 2mg/kg taken for longer than 2 weeks), iron supplementation (see notes on this below).
Immune Reconstitution Syndrome
It is important to remember that if HIV has destroyed your immune system and you then start treatment, whether ART or an alternative therapy, you may start producing symptoms of something called immune reconstitution syndrome. Because your immune system has been so weak it has not even been able to produce the symptoms of various organisms (viruses, bacteria, etc) that have infected your body. Once your immune system improves (because of some form of treatment) it will start showing these hidden infections. But this is a good sign.
Post Exposure Prophylaxis (PEP)
If you suspect that you may have been exposed to HIV in anyway you should go to a hospital emergency and request post exposure prophylaxis ART. This applies to rape, needle-stick injury, and any other exposure to blood products. Perhaps you’ve helped someone at the scene of an accident and were exposed to his or her blood while you too were injured. Even if another person’s blood comes in contact with a cut on your hand, go for PEP and an HIV test!
With PEP you have the opportunity to eradicate the virus… if you commence treatment within 72 hours. In other works you don’t have to end up HIV positive. Your chances improve if you commence PEP with 12 hours. Time is of the essence! Hurry!
One of the best options in Gauteng is Millpark Clinic (we’ve tried it out). Some medical aids (e.g. Discovery Health) cover PEP. PEP will have to be taken for no more and no less than 28 days! It should be composed of a 2-drug regime (to prevent developing resistance), often combined and given as something called Combivir. A number of other blood test will be done to ensure your safety (i.e. can your body cope with the side effects?). The HIV test and other blood tests will be repeated at 2 weeks, 4 weeks, 3 months and 6 months. Please use a condom during those 6 months (until you’ve been proven clear) to protect your partner.
CLICK HERE TO EMAIL CORNELIA FOR THE FULL DOCUMENT
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